key: cord-1012375-gatdb2bm
authors: Jeffries, J. Joel
title: Reflecting on my experience after coronary artery bypass grafting
date: 2021-09-13
journal: CMAJ
DOI: 10.1503/cmaj.79961
sha: 333cb538872d2668c06ce47f2148275b66a995de
doc_id: 1012375
cord_uid: gatdb2bm

nan

I am prompted to respond to the CMAJ article "Management of Patients After Coronary Artery Bypass Grafting Surgery: A Guide for Primary Care Practitioners." 1 I compared my own experience 14 months ago, when I had double bypass surgery, with the typical outcomes detailed in the article.

I was not readmitted within 30 days, as occurs in patients older than 80 years (I was 81).

I did not develop cardiac tamponade, which occurs in 1%-12.6% of patients.

I did not have a perioperative myocardial infarction, which occurs in 0.6%-19% of patients.

I have not had a graft occlusion, which occurs in 2%-5% of patients per annum.

I did not develop pneumonia, which occurs in 2.4% of patients.

I did not have any cognitive dysfunction, which affects 50%-70% of patients. I did not develop depression, euphoria or anxiety.

I did not have postoperative delirium, which affects 73% of patients.

I did not develop kidney dysfunction, which affects 30% of patients.

I did not develop atrial fibrillation, which affects 30% of patients.

Not seeing a general practitioner (GP) within 30 days is associated with 5 times worse outcomes. I did not get to see my GP within 30 days because of the COVID-19 pandemic, and have not seen her yet, although I have had the best possible care by telephone.

It therefore appears that my outcome was remarkably good, for which I am very thankful. Two factors may have helped: for an electrophysiology study, I was kept in hospital an extra 4 days; then, for 5 days, I had phone access to a skilled nurse practitioner.

This leads me to 2 reflections. 1. I am happy I was not aware of the possible outcomes described in the article, as I would have been full of trepidation. 2. I actually had complications not mentioned by the authors in their literature review, which focused on dire outcomes. These were as follows: a) Pain on coughing or sneezing which, I was informed, might have been a result of minor cracks in my ribs. b) Dehiscence of a leg wound -the site of harvest of my left saphenous vein graft, which took 4 months to heal. c) Electric shock feelings in the lower left leg, which went on for 9 months and were attributed to nerves being cut during the saphenous harvesting. d) Swelling of the lower left leg, which I am told is permanent, although now minimal. e) Feelings of light-headedness when walking; it was discovered I had developed iron-deficiency anemia. 

Management of patients after coronary artery bypass grafting surgery: a guide for primary care practitioners

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